This MDTool allows you to compare your fees for up to 25 CPT® codes with Medicare fees for your geographic area for any year between 2002 and 2019.
The Medicare Physician Fee Schedule Analyzer will calculate your fees as a percent of the corresponding Medicare fee for the year chosen. This tool also allows you to create fee schedules based on two user-defined percentages of Medicare.
This tool is updated quarterly and annually to reflect Medicare's current fees.
Enter the information requested below. Your zip code is required in order to return area-specific Medicare fees and comparisons.
Medicare Fee Schedule Analyzer
Please enter the your zip code and other information below for Medicare fee schedule information. Your zip code is necessary to map your
CMS carrier, locality, and fee triplet.
References 1. CPT - Current Procedural Terminology codes copyrighted by American Medical Association.
2. Par Fee - The fee allowed by Medicare for services provided by participating physicians.
A participating physician agrees to accept Medicare's allowable as the full fee for the service provided.
Medicare pays 80% of the allowed fee to the physician.
3. Non Par Fee - The fee allowed by Medicare for services provided by non-participating physicians.
This fee is 95% of the Medicare Par Fee. Medicare pays 80% of the Non-Par allowed fee to the patient or
the physician depending on whether the non participating physician accepts assignment on the claim.
4. Limiting Charge - The maximum amount that a non participating physician can charge a Medicare beneficiary.
This amount is 115% of the Non Par Fee.
CPT is a registered trademark of the American Medical Association. CPT copyright 2013 American Medical Association. All rights reserved.